St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR

Professional

Both

$516.32

Service Code	HCPCS 36160
Min. Negotiated Rate	$387.24
Max. Negotiated Rate	$387.24
Rate for Payer: Cash Price	$138.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$387.24
Rate for Payer: SOMOS Essential	$387.24

PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY

Professional

Both

$675.43

Service Code	HCPCS 36100
Min. Negotiated Rate	$506.57
Max. Negotiated Rate	$506.57
Rate for Payer: Cash Price	$178.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$506.57
Rate for Payer: SOMOS Essential	$506.57

PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY

Professional

Both

$386.65

Service Code	HCPCS 36140
Min. Negotiated Rate	$289.99
Max. Negotiated Rate	$289.99
Rate for Payer: Cash Price	$102.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$289.99
Rate for Payer: SOMOS Essential	$289.99

PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ

Professional

Both

$4,722.59

Service Code	HCPCS 44615
Min. Negotiated Rate	$3,541.94
Max. Negotiated Rate	$3,541.94
Rate for Payer: Cash Price	$1,268.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,541.94
Rate for Payer: SOMOS Essential	$3,541.94

PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE

Professional

Both

$599.76

Service Code	HCPCS 31500
Min. Negotiated Rate	$449.82
Max. Negotiated Rate	$449.82
Rate for Payer: Cash Price	$160.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$449.82
Rate for Payer: SOMOS Essential	$449.82

PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES

Professional

Both

$130.66

Service Code	HCPCS 95940
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$98.00
Rate for Payer: Cash Price	$35.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$98.00
Rate for Payer: SOMOS Essential	$98.00

PR IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED

Professional

Both

$130.69

Service Code	HCPCS 99175
Min. Negotiated Rate	$98.02
Max. Negotiated Rate	$98.02
Rate for Payer: Cash Price	$35.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$98.02
Rate for Payer: SOMOS Essential	$98.02

PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES

Professional

Both

$443.25

Service Code	HCPCS 99255
Min. Negotiated Rate	$332.44
Max. Negotiated Rate	$332.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$332.44
Rate for Payer: SOMOS Essential	$332.44

PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES

Professional

Both

$255.75

Service Code	HCPCS 99253
Min. Negotiated Rate	$191.81
Max. Negotiated Rate	$191.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$191.81
Rate for Payer: SOMOS Essential	$191.81

PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES

Professional

Both

$364.50

Service Code	HCPCS 99254
Min. Negotiated Rate	$273.38
Max. Negotiated Rate	$273.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$273.38
Rate for Payer: SOMOS Essential	$273.38

PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES

Professional

Both

$162.00

Service Code	HCPCS 99252
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$121.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$121.50
Rate for Payer: SOMOS Essential	$121.50

PR IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY

Professional

Both

$4,499.88

Service Code	HCPCS 66605
Min. Negotiated Rate	$3,374.91
Max. Negotiated Rate	$3,374.91
Rate for Payer: Cash Price	$1,234.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,374.91
Rate for Payer: SOMOS Essential	$3,374.91

PR IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX

Professional

Both

$2,354.24

Service Code	HCPCS 66635
Min. Negotiated Rate	$1,765.68
Max. Negotiated Rate	$1,765.68
Rate for Payer: Cash Price	$649.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,765.68
Rate for Payer: SOMOS Essential	$1,765.68

PR IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX

Professional

Both

$1,770.76

Service Code	HCPCS 66625
Min. Negotiated Rate	$1,328.07
Max. Negotiated Rate	$1,328.07
Rate for Payer: Cash Price	$487.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,328.07
Rate for Payer: SOMOS Essential	$1,328.07

PR IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES

Professional

Both

$3,773.74

Service Code	HCPCS 66600
Min. Negotiated Rate	$2,830.30
Max. Negotiated Rate	$2,830.30
Rate for Payer: Cash Price	$1,033.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,830.30
Rate for Payer: SOMOS Essential	$2,830.30

PR IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX

Professional

Both

$2,333.03

Service Code	HCPCS 66630
Min. Negotiated Rate	$1,749.77
Max. Negotiated Rate	$1,749.77
Rate for Payer: Cash Price	$643.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,749.77
Rate for Payer: SOMOS Essential	$1,749.77

PR IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS

Professional

Both

$1,749.13

Service Code	HCPCS 66762
Min. Negotiated Rate	$1,311.85
Max. Negotiated Rate	$1,311.85
Rate for Payer: Cash Price	$482.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,311.85
Rate for Payer: SOMOS Essential	$1,311.85

PR IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION

Professional

Both

$973.42

Service Code	HCPCS 66761
Min. Negotiated Rate	$730.06
Max. Negotiated Rate	$730.06
Rate for Payer: Cash Price	$268.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$730.06
Rate for Payer: SOMOS Essential	$730.06

PR IRIDOTOMY STAB INC SPX TRANSFIXION

Professional

Both

$1,792.11

Service Code	HCPCS 66505
Min. Negotiated Rate	$1,344.08
Max. Negotiated Rate	$1,344.08
Rate for Payer: Cash Price	$492.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,344.08
Rate for Payer: SOMOS Essential	$1,344.08

PR IRIDOTOMY STAB INC SPX XCP TRANSFIXION

Professional

Both

$1,652.98

Service Code	HCPCS 66500
Min. Negotiated Rate	$1,239.74
Max. Negotiated Rate	$1,239.74
Rate for Payer: Cash Price	$453.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,239.74
Rate for Payer: SOMOS Essential	$1,239.74

PR IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST

Professional

Both

$109.80

Service Code	HCPCS 96523
Min. Negotiated Rate	$82.35
Max. Negotiated Rate	$82.35
Rate for Payer: Cash Price	$29.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$82.35
Rate for Payer: SOMOS Essential	$82.35

PR IRRIGATION CORPORA CAVERNOSA PRIAPISM

Professional

Both

$569.66

Service Code	HCPCS 54220
Min. Negotiated Rate	$427.24
Max. Negotiated Rate	$427.24
Rate for Payer: Cash Price	$156.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$427.24
Rate for Payer: SOMOS Essential	$427.24

PR IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE

Professional

Both

$111.83

Service Code	HCPCS 57150
Min. Negotiated Rate	$83.87
Max. Negotiated Rate	$83.87
Rate for Payer: Cash Price	$29.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$83.87
Rate for Payer: SOMOS Essential	$83.87

PR ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB

Professional

Both

$227.78

Service Code	HCPCS 95875 26
Min. Negotiated Rate	$170.84
Max. Negotiated Rate	$170.84
Rate for Payer: Cash Price	$63.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.84
Rate for Payer: SOMOS Essential	$170.84

PR ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB

Professional

Both

$572.64

Service Code	HCPCS 95875
Min. Negotiated Rate	$429.48
Max. Negotiated Rate	$429.48
Rate for Payer: Cash Price	$140.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$429.48
Rate for Payer: SOMOS Essential	$429.48

Know your out-of-pocket cost for care.

All Charges